SPECIFIC IMMUNE-RESPONSE AGAINST GARDNERELLA-VAGINALIS HEMOLYSIN IN PATIENTS WITH BACTERIAL VAGINOSIS

OBJECTIVE: Our goal was to study the mucosal host response in bacteria l vaginosis by evaluating the presence of a specific immune response e licited against the Gardnerella vaginalis hemolysin in vaginal fluids of patients and by verifying its correlation with usual criteria adopt ed to diagnose bacterial vaginosis. STUDY DESIGN: A total of 123 white women attending the gynecologic care unit for urogenital complaints o r for screening of uterine malignancies (Papanicolaou test) aged from 20 to 60 years, nonmenstruating, were enrolled. Bacterial vaginosis wa s diagnosed by clinical criteria and a Gram stain score >6. RESULTS: W e performed the determination of the antibody response in vaginal flui d against the hemolysin produced by G. vaginalis, a common agent prese nt in bacterial vaginosis. The purified G. vaginalis toxin was a suita ble antigen for detecting the presence of an immune response in the va ginal fluids of patients with bacterial vaginosis regardless of the st rain of G. vaginalis present. A specific immunoglobulin A response was detected in 60% of women with overt bacterial vaginosis (Gram stain s core >6) and in 18.5% of women with intermediate vaginal flora (Gram s tain score 4 to 6). The specificity of the test was 91%. CONCLUSIONS: We found a correlation between the specific local immune response to G . vaginalis toxin and bacterial vaginosis. The highly purified form of the toxin is able to discriminate disorders from the opportunistic co lonization by G. vaginalis.